Nailfold capillaries and myositis-specific antibodies in anti–melanoma differentiation–associated gene 5 antibody-positive dermatomyositis

Abstract

Objectives This study aimed to quantify nailfold capillary (NFC) abnormalities in anti-melanoma differentiation-associated gene 5 (MDA5)-positive dermatomyositis (DM) patients and to evaluate the association with clinical parameters, including serum biomarkers. In addition, we aimed to clarify the period leading to remission of NFC abnormalities during immunosuppressive treatment in patients with DM. Methods A prospective observational study was conducted including patients (n = 10) who first visited Hiroshima University Hospital and were diagnosed with DM or clinically amyopathic dermatomyositis (CADM) with anti-MDA5 antibodies. We compared the NFC abnormalities detected by nailfold-video capillaroscopy (NVC), physical findings, blood tests, respiratory function tests, and vascular-related growth factors measured using a LEGENDplexTM Multi-Analyte Flow Assay Kit. Results NFC abnormalities improved in all patients from 2–17 weeks after the initiation of immunosuppressive treatment. The NVC scores were inversely correlated with anti-MDA5 antibody titres at baseline. NVC scores and forced vital capacity (FVC) were positively correlated. Baseline with macrophage colony-stimulating factor (M-CSF) and stem cell factor (SCF) was correlated with anti-MDA-5 titres. Conclusion Our study suggests that NVC scores and disease activity are inversely correlated before treatment. Vascular-related growth factors, such as M-CSF and SCF, may be associated with the disease mechanism in patients with anti-MDA5 antibody-positive DM.

The Expression of Cytokine Profiles and Related Receptors in Idiopathic Inflammatory Myopathies

“…Moreover, according to the MSAs classification, we found that the expression of CTACK, Eotaxin, IL1Rα, IL7, IL18, IP10, MCP1, MCP3, MCSF, MIG and SCGFβ were differentially expressed in anti-ARS positive, anti-MDA5 positive, anti-TIF1γ positive IIMs compared with HC groups. These results were partially consistent with those of previous reports ( Gono et al, 2010 ; Gono et al, 2014 ; Zou et al, 2016 ; Chen et al, 2018 ; Bai et al, 2020 ; Sugimoto et al, 2021 ). In addition, serum SCGFβ and CTACK were first found to be increased in IIMs and anti-MDA5 positive patients, respectively.…”

Nailfold capillaroscopy changes with disease activity in patients with inflammatory myositis including overlap myositis, pure dermatomyositis, and pure polymyositis

“…Recent studies also showed that there are inverse correlations between NVC scores and disease activity before treatment (n = 10) and that the density can Reumatologia 2022; 60/1 be a dynamic marker of global disease activity in adult patients (n = 15) with DM that can be improved after treatment [12,13].…”

“…The capillaroscopy parameters were evaluated by stereomicroscopy in power of × 250: distribution, morphology of capillaries, dimensions based on the largest diameter of the apical side (dilated > 20 μm, giant > 50 μm), capillary length (normal or elongated: ≥ 300 μm), mean capillary density (low density was defined as reduction of the normal number of the capillaries below 7 per linear millimetre), avascular area (intercapillary distance > 500 μm), and microhaemorrhages [13,14], based on the last standardization of NFC and International Delphi consensus for reporting the data (2020).…”

“…There are some articles with limited numbers of patients for the evaluation of capillaroscopy in patients with OM [12,13], and a few articles pulling the patients with OM from patients with PM/DM to find the differences between these patients in their clinical and capillaroscopy features [14,15].…”

Comment on: Combination of immunosuppressive therapy and nintedanib improves capillaroscopic changes in systemic sclerosis–interstitial lung disease: a case report

“…We consider that the vascular abnormalities in the study by Matsuda et al [ 1 ] were mild and could be improved to almost normal. We have previously reported that even in patients with SLE and DM, nailfold capillary abnormalities can be improved by drug therapy without the use of antifibrotic drugs [ 5 , 6 , 7 ]. We believe that further verification is needed to determine whether nintedanib improves nailfold capillary abnormalities.…”